The Brand New Day Medication Therapy Management (MTM) Program is offered to members who use a number of Part D covered prescription drugs and have a number of medical conditions. The program helps members and doctors manage the prescribed drugs and reduce potential problems. This program is not considered a benefit. It is a free service for all eligible members. Your participation in the program is voluntary but we encourage you to work with our MTM provider to take full advantage of the program.
You will be automatically enrolled in the MTM program when you meet the following conditions: You spend more than $4,255 per year on your Part D medications or $1,063.75 every three (3) months and you take at least seven (7) Part D covered prescription drugs and;
you have a minimum of three (3) of the following chronic diseases:
- Cardiovascular Disease
- Diabetes (high blood sugar)
- Dyslipidemia (high cholesterol)
- Hypertension (high blood pressure)
- Chronic Obstructive Pulmonary Disease
You will be invited to participate in this program designed for your specific health and pharmacy needs. A welcome letter is sent to eligible members within 30 days when you become eligible, which provides details of the program and an offer to schedule a Comprehensive Medication Review (CMR).
Comprehensive Medication Review (CMR)
You will be offered the opportunity to have a CMR in an interactive conversation between you, your caregiver or other authorized individual you select to participate and a Pharmacist, a Registered Nurse or other qualified provider. The conversation is conducted at least annually with you whether you live at home or in a long-term care facility. The conversation may take up to 30 minutes.
During the CMR, the provider will help you develop a Medication Action Plan (MAP) to:
- Ensure you are being prescribed the most appropriate drug(s) for your condition(s).
- Help you understand the best way to take your prescribed drugs for the desired results.
- Discuss possible ways to reduce your costs for prescription drugs.
- Provide you with a Personal Medication List (PML) to keep track of the medications you take so that you can take the PML with you when you see your doctor.
Both the MAP and the PML will be mailed to you after the CMR.
In addition to the CMR described above, the MTM provider also conducts quarterly reviews of your medications to make sure there are no interactions among the drugs, you receive the most appropriate drugs for your conditions and if necessary, the provider will reach out to your doctor if they have suggestions. We call this process Targeted Medication Review.
Medicare’s Website About Medication Therapy Management
Medicare has a page on its website about Medication Therapy Management.